Viral Hepatitis Flashcards
What does Surface antigen (HBsAg) show?
An active infection
What does E antigen (HBeAg) show?
Marker of viral replication and implies high infectivity
What do core antibodies (HBcAB) show?
Implies past or current infection
What does surface antibody (HBsAb) show?
Implies vaccination or past or current infection
What does Hepatitis B virus DNA (HBV DNA) show?
This is a direct count of the viral load
What is an incubation period?
The time from the moment of exposure to an infectious agent until signs and symptoms of the disease appear
What does IgM indicate?
Acute infection
What does IgG indicate?
Previous infection or memory
What does the development of Hepatitis A look like?
Either recover (most common) or have fulminant hepatitis (1-2%)
- Hepatitis A and E cause AcutE hepatitis
How is Hepatitis A spread?
- Faeco-oral
- Shellfish
Where is Hepatitis A most prevalent?
- Endemic in Africa and S America
Common in Children
What is the serology for Hepatitis A?
- Hepatitis A viral RNA appears in stool after 1 week
- Transaminases rise 22-40 days after exposure
- IgM rises from day 25
- IgG detectable for life
What is the preventative treatment for Hepatitis A?
- Vaccination
1st dose: 1yr immunity
2nd dose: 20yr immunity
Can hepatitis A be treated?
Usually doesn’t need treatment as is self-limiting
What is the incubation period for Hepatitis A?
2-6 weeks
What determines progression of Hepatitis B to a chronic infection?
- Age
<1 year 90% chronic
1-5 years 30% chronic
>5 years 1-5% chronic
- Immunosuppression
- Route of infection
- GenotypeWhat does Hepatitis B have a strong association with?
Liver cancer
How is Hepatitis B spread?
- Vertical transmission from mother to child
- Sexual
- Blood
IV drug users (IVDU), medical - Sharing contaminated household products
What is the serology for an acute Hepatitis B infection?
- Anti-core IgM
Early rise - HBsAg
Present for 1-6months
What does anti-HBc imply?
Past infection
What does anti-HBs alone imply?
Vaccination
What is the preventative treatment for Hepatitis B?
- Immunisation
3 doses
Immunise all sexual partners
Can acute hepatitis B be treated?
Most people fully recover without treatment
What is the serology for an chronic Hepatitis B infection?
- HbsAg > 6 months
HBeAg +ve = high viral load, infection, normal LFTs, few liver problems
HBeAb +ve = low viral load, raised transaminases, liver fibrosis and cirrhosis
Can chronic hepatitis B be treated?
- Antivirals
- Interferons
Give to HBeAg +ve
What is the incubation period for hepatitis B?
1-6 months
What does the development of Hepatitis C look like?
- 25% Recover
- 75% Chronic hepatitis
How is Hepatitis C spread?
- Blood
- Sexual
- Vertical
What is the serology for an acute Hepatitis C infection?
- Anti-HCV
- HVC-PCR
RNA -ve
Have been exposed to, but now cleared the virus
Can chronic hepatitis C be treated?
- Inferferon
Ribavirin - Protease inhibitors
Can be re-infected after treatment
What does the development of Hepatitis E look like?
Same as hepatitis A
How is Hepatitis E spread?
- Faecal-oral route
- Undercooked pork, wild boar and deer
When may Hepatitis E cause severe disease?
2nd trimester of pregnancy
What is the serology for a Hepatitis E infection?
- HEV IgM = active infection
- HEV IgG = recovery
What does the development of Hepatitis Delta look like?
- Requires co-infection with Hepatitis B
- Worsens prognosis of Hepatitis B
What is the serology for a Hepatitis Delta infection?
- Anti-HDV antibody
Only ask if HBsAg +ve
